ASSESSING CAREGIVING SUPPORT NETWORKS FOR PERSONS WITH DEMENTIA IN A LONG-TERM CARE CONTEXT IN CHINA AND THE US

Abstract Informal caregivers are vital to the provision of care for persons living with dementia (PLWD). Although PLWD often receive care from multiple sources, little is known about the broad caregiving support networks that PLWD have. Furthermore, the structure of caregiving support networks is likely influenced by the availability, accessibility, and affordability of LTC services. Therefore, caregiving support networks in China and in the U.S. are likely to differ. In this study, we identified the major types of caregiving support networks that PLWD have using the Health and Retirement Study and China Health and Retirement Longitudinal Study. Results from latent class analysis show that both countries have three major types of caregiving networks, but they differ in the proportion of each country’s population that follow each type. Unlike conventional secondary data studies that often only focus on existing data, we are working with WE-THRIVE Consortium to further gain a comprehensive understanding of the dementia care context in China and in the U.S. Through an expert panel survey, we will assess the scope, services, needs, funding, and ownerships of LTC in each country. We will then link the data from expert survey to the two national aging studies to contextualize the caregiving support networks in persons with dementia. This new way of linking existing individual-level with country-level data is directly responsive to the priority research areas identified by the National Academy of Medicine and will shed light on which caregiving support networks need more external formal support to promote person-centered dementia care.


UNDERSTANDING PERSON-CENTERED CARE FOR OLDER PEOPLE IN SIX DEVELOPING COUNTRIES
Jing Wang 1 , and Barbara Bowers 2 , 1. University of New Hampshire, Durham, New Hampshire, United States, 2. University of Wisconsin-madison, Madison, Wisconsin, United States Person-centered care (PCC) is a widely acknowledged and encouraged approach to quality care for older adults residing in residential care facilities.However, current understandings of PCC are mainly based on research and practice in western, first world nations.The lack of research on PCC in developing countries leads to uncertainty over whether and how current understandings of PCC apply to cultures and contexts in non-western, developing countries.To enhance care and outcomes for diverse populations, it is crucial to comprehend and culturally adapt PCC understandings and approaches.Therefore, we conducted interviews with researchers and practitioners from six countries in various stages of development to identify elements that form the core of high-quality care for older people and how they relate to Western notions of PCC.We gained valuable insights into how cultural differences, population health priorities, political conflict, and limited resources impact their understanding and implementation of PCC.In addition to variations in the language of PCC, some first world assumptions about PCC do not resonate well in developing countries.One example is the emphasis on individualism, a basic element of PCC.The role of the older person in decision making and focus on family and community priorities reflects both cultural and economic differences between first world, western nations and non-western, developing countries.The findings can serve as a valuable starting point for the development of a globally applicable measurement for the quality of care.Informal caregivers are vital to the provision of care for persons living with dementia (PLWD).Although PLWD often receive care from multiple sources, little is known about the broad caregiving support networks that PLWD have.Furthermore, the structure of caregiving support networks is likely influenced by the availability, accessibility, and affordability of LTC services.Therefore, caregiving support networks in China and in the U.S. are likely to differ.In this study, we identified the major types of caregiving support networks that PLWD have using the Health and Retirement Study and China Health and Retirement Longitudinal Study.Results from latent class analysis show that both countries have three major types of caregiving networks, but they differ in the proportion of each country's population that follow each type.Unlike conventional secondary data studies that often only focus on existing data, we are working with WE-THRIVE Consortium to further gain a comprehensive understanding of the dementia care context in China and in the U.S. Through an expert panel survey, we will assess the scope, services, needs, funding, and ownerships of LTC in each country.We will then link the data from expert survey to the two national aging studies to contextualize the caregiving support networks in persons with dementia.This new way of linking existing individual-level with country-level data is directly responsive to the priority research areas identified by the National Academy of Medicine and will shed light on which caregiving support networks need more external formal support to promote person-centered dementia care.

BUILDING BRIDGES, CATALYZING RESEARCH, EMPOWERING ALL AGES: NIA SESSION FOR EARLY-CAREER RESEARCHERS
Chair: Amy Kelley Discussant: Amy Kelley The National Institute on Aging (NIA) at the National Institutes of Health, Department of Health and Human Services, supports biomedical and behavioral research with a lifespan focus.NIA research seeks to understand the basic processes of aging, improve prevention and treatment of diseases in later life, and improve the health of older persons, in addition to an emphasis on Alzheimer's disease and related dementias.NIA supports a variety of training and career development opportunities for students, junior faculty, early-career investigators, and emerging scholars.In this session, we will provide an overview of NIA-funded research, followed by a presentation on funding mechanisms and strategies to consider when applying for extramural grants, particularly for early-career scientists at multiple career stages.Finally, attendees will be able to join any number of breakout group discussions (led by extramural NIA training staff and program officials) to discuss programs, initiatives, mechanisms, and/or policies specific to various career paths.

WHO CARES? RETENTION STRATEGIES FOR DIRECT CARE WORKERS
Chair: Robert Applebaum Co-Chair: Leah Janssen Discussant: Robert Applebaum More than 30 years ago the Gerontological Society sponsored a congressional briefing about a growing problem; concerns about the adequacy and quality of the direct care workforce in long-term care.In 2002 the Robert Wood Johnson Foundation sponsored the Better Jobs, Better Care demonstration, in response to this continued challenge.Today recruiting and retaining high quality workers in the long-term services system has moved beyond a challenge to an all-out crisis.The initial paper of the symposium presents recent retention and work culture data highlighting todays' hurdles, collected from more than 80% of long-term care facilities across Ohio.The second presentation provides a comprehensive review of state-level initiatives and innovations aimed at improving recruitment and retention for direct care workers (DCWs) in both facility-based long-term care and home and community-based long-term services across the country.A third paper focuses on retention-promoting factors from the perspective of providers and DCWs working in high-performing long-term care facilities in Ohio.In-depth interviews with 37 providers and DCWs revealed an overarching theme of the importance of work culture, highlighting the modifiable, intangible aspects for promoting DCW retention.The final paper introduces a tip sheet with practical strategies for providers who are seeking to retain direct care workers.Symposium findings will include both practical implications for long-term care providers and ideas for future studies.The direct care workforce crisis is the result of an array of challenges, which means that there will not be one solution, but rather many ideas will be needed.

PRACTICAL STRATEGIES FOR RETAINING DIRECT CARE WORKERS
Leah Janssen, Scripps Gerontology Center / Miami University, Oxford, Ohio, United States Direct care workers (DCWs), such as state-tested nurse aides, personal care aides, and home care aides are a critical component of the long-term services system.While there is consensus in both the research and practice community on the challenges faced, the plan for a long-term solution continues to be developed.The final paper of this symposium is based on a review of state and national initiatives and interviews with high-performing long-term services and support providers, and culminates into a tip sheet of practical strategies for providers who are seeking to recruit and retain DCWs.The tip sheet is organized in relation to the symposium theme of work culture, which includes elements of creating a welcoming and respectful work environment, employing a participative leadership model, and opportunities for DCWs to anonymously assess work culture.It also discusses staffing ratios that are critical to recruiting and retaining workers, as well as an examination of career ladders,

Abstract citation ID: igad104.0970 ASSESSING CAREGIVING SUPPORT NETWORKS FOR PERSONS WITH DEMENTIA IN A LONG-TERM CARE CONTEXT IN CHINA AND THE US Hanzhang
Xu 1 , Matthew Dupre 1 , Scott Lynch 1 , Truls Østbye 2 , and Bei Wu 3 , 1. Duke University, Durham, North Carolina, United States, 2. Duke University School of Medicine, Durham, North Carolina, United States, 3. New York University, New York City, New York, United States